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    肺结节诊治相关指南共识的质量评价

    Appraisal of Guidelines and Consensuses on Management of Pulmonary Nodules

      摘要
    • 摘要:
      目的 基于AGREEⅡ（the Appraisal of Guidelines for Research & Evaluation Instrument Ⅱ）对肺结节诊治相关指南共识的方法学质量进行评价。
      方法 检索CNKI、WanFang、VIP、SinoMed、Yiigle、PubMed、Embase、Web of Science数据库和WHO、GIN、NGC、NICE、中华人民共和国国家卫生健康委员会、中华医学会、中华中医药学会、中国中西医结合学会等官方网站，采集肺结节诊治相关的指南共识，并从医脉通进行补充，检索时限均为从建库至2023-12-16。由4名研究人员基于AGREE Ⅱ对纳入的指南共识进行方法学质量评价。
      结果 共纳入肺结节诊治相关的指南共识37部，其中指南11部、共识26部，中文22部、英文15部。纳入的37部指南共识，在AGREE Ⅱ的6个领域的平均标准化得分依次为：范围和目的（76.28%）、利益相关者的参与（41.82%）、严谨性（36.78%）、清晰性（71.55%）、应用性（34.88%）、编辑独立性（48.03%）。亚组分析结果显示，中英文文献在6个领域的得分皆无统计学差异；但在其他亚组，6个领域的得分皆为指南高于共识、基于循证证据高于基于专家意见、更新版本高于初版、参与制订的专家数≥20高于专家数≤19。
      结论 肺结节诊治相关指南共识在制订过程中利益相关者的参与、形成推荐意见的严谨性、对于预期应用性的考虑、制订过程独立性的报道这4个方面的方法学质量还有待提高。建议国内外学术组织在未来能够参考AGREE Ⅱ等规范进行指南共识的制订和更新。

       

      Abstract:
      Objective To evaluate the methodological quality of guidelines and consensuses related to the management of pulmonary nodules according to AGREE II (The Appraisal of Guidelines for Research & Evaluation Instrument II).
      Methods CNKI, WanFang, VIP, SinoMed, Yiigle, PubMed, Embase, Web of Science databases and the official websites of WHO, GIN, NGC, NICE, National Health Commission of People’s Republic of China, Chinese Medical Association, China Association of Chinese Medicine, Chinese Association of Integrative Medicine, etc. were searched to collect guidelines and consensuses related to the management of pulmonary nodules, supplemented from Medlive, the search period ranged from the conception of the databases to 2023-12-16. The methodological quality of the included guidelines and consensuses was evaluated by four researchers according to AGREE Ⅱ.
      Results A total of 37 guidelines and consensuses related to the management of pulmonary nodules were included, including 11 guidelines and 26 consensuses, 22 in Chinese and 15 in English. The mean standardized scores of the 37 included documents in the six domains of AGREE Ⅱ were: scope and purpose (76.28%), stakeholder involvement (41.82%), rigor of development (36.78%), clarity of presentation (71.55%), applicability (34.88%), and editorial independence (48.03%). Subgroup analyses demonstrated no statistically significant difference found between the scores of Chinese and English literatures in any of the six domains; however, in other subgroups, the scores in all six domains were higher for guidelines than for consensuses, evidence-based than for expert opinion-oriented, updated versions than for first editions, and the number of participated experts ≥20 than for the number ≤19.
      Conclusion The methodological quality of guidelines and consensuses for the management of pulmonary nodules needs to be improved in terms of stakeholder involvement in the development process, rigor in the process from evidence into recommendations, consideration of intended applicability, and the reporting of editorial independence. It is recommended that domestic and international academic organizations should refer to standards such as AGREE Ⅱ for the development and updating of guidelines and consensuses in the future.

       

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